U100plus双频双脉冲激光在输尿管结石治疗中的应用

U100plus Laser Lithotripsy for the Treatment of Ureteral Stones

目的探讨输尿管镜下应用U100plus激光治疗输尿管结石的疗效。方法 2006年12月～2010年9月,对257例输尿管结石实施输尿管镜下U100plus激光碎石术,设置激光脉冲能量120 mJ,频率10 Hz。放置输尿管双J管7～30 d。结果 221例(86.0%)结石一次粉碎成功,其中输尿管上段结石82.0%(73/89),中、下段结石88.1%(148/168)。7例二次碎石成功,总碎石成功率88.7%(228/257)。手术时间15～65 min,(23.4±5.1)min,激光工作时间2～44 min,(12.3±3.3)min。双J管拔出后2周复查B超,结石排净率96.1%(219/228)。术后肾绞痛35例,未发生严重并发症。结论 U100plus激光碎石术治疗输尿管结石具有快速、高效、组织创伤极小、安全、操作简单等优点,可作为输尿管结石的首选治疗方法。

Objective To evaluate the efficacy of ureteroscopic U100plus laser lithotripsy for ureteral stones.MethodsFrom December 2006 to September 2010,under a ureteroscope,we performed U100plus laser lithotripsy on totally 257 patients with ureteral stones.The laser pulse energy was set at 120 mJ,and the frequency was at 10 Hz.Double-J tube was placed at the end of the procedure and was withdrawn in 7 to 30 days.Results The procedure was completed in a mean of（23.4±5.1） min（15-65 min）,during which,the laser operation time was（12.3±3.3） min in average（2-44 min）.The rate of one-session success was 86.0%（221/257） in all the patients,and was 82.0%（73/89） in the patients with upper ureteral stones,and 88.1%（148/168） in those with middle and lower ureteral stones.Second-session success was achieved in 7 patients;and therefore the total success rate was 88.7%（228/257）.Two weeks after the double-J tube was removed,B-ultrasonography showed stone free in 219 of the patients（219/228,96.1%）.After the operation,35 patients developed renal colic,but no severe complications occurred.ConclusionsU100plus laser lithotripsy is a quick,effective,safe,and less invasive procedure.We recommend it as the first choice for the treatment of ureteral stones.